Epidemic cholera among refugees in Malawi, Africa: treatment and transmission
Between 23 August and 15 December 1990 an epidemic of cholera affected Mozambican refugees in Malawi causing 1931 cases (attack rate=2·4%); 86% of patients had arrived in Malawi
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| Veröffentlicht in: | Epidemiology and infection 1997-06, Vol.118 (3), p.207-214 |
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| creator | SWERDLOW, D. L. MALENGA, G. BEGKOYIAN, G. NYANGULU, D. TOOLE, M. WALDMAN, R. J. PUHR, D. N. D. TAUXE, R. V. |
| description | Between 23 August and 15 December 1990 an epidemic of cholera affected
Mozambican
refugees in Malawi causing 1931 cases (attack rate=2·4%); 86% of
patients had arrived in
Malawi |
| doi_str_mv | 10.1017/s0950268896007352 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2808810</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><cupid>10_1017_S0950268896007352</cupid><jstor_id>4617355</jstor_id><sourcerecordid>4617355</sourcerecordid><originalsourceid>FETCH-LOGICAL-c623t-fcde3b94f4df0c26074b84e31be791edb5b45be8ea0e589ee74dedb950fdb13f3</originalsourceid><addsrcrecordid>eNp9kUtv1DAUhS0EKkPhByCBlEXFioAdO3bMolJVlbbqA1WUteXHzdRDEg92wuPf49FEEbBgZdnf8b33nIvQS4LfEUzE-4RljSveNJJjLGhdPUIrwrgsGcPyMVrtcLnjT9GzlDYYY1k14gAdyAoLQfEK3ZxtvYPe28I-hA6iLnQfhnURoZ3WAKnwQ3GjO_3Dvy1O2uit_lCMEfTYwzAWenD5pofU-5R8GJ6jJ63uEryYz0P05ePZ_elFef3p_PL05Lq0vKJj2VoH1EjWMtdiW3EsmGkYUGJASALO1IbVBhrQGOpGAgjm8ms20zpDaEsP0fG-7nYyPTibZ4m6U9voex1_qaC9-psM_kGtw3dVNbhpCM4F3swFYvg2QRpVdmCh6_QAYUqK8EpwzkQWkr3QxpBSTmVpQrDa7UB9_ncH-c_rP6dbfsyhZ340c52s7tocoPVpkVVc5hR2rV_tZZs0hrhgxjOr64zLPfZphJ8L1vGr4oKKWvHzO8VvL67YLb1Xd1lPZye6N9G7NahNmOKQ9_QfL78BmhO4nQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>16276647</pqid></control><display><type>article</type><title>Epidemic cholera among refugees in Malawi, Africa: treatment and transmission</title><source>MEDLINE</source><source>JSTOR Archive Collection A-Z Listing</source><source>PubMed Central</source><creator>SWERDLOW, D. L. ; MALENGA, G. ; BEGKOYIAN, G. ; NYANGULU, D. ; TOOLE, M. ; WALDMAN, R. J. ; PUHR, D. N. D. ; TAUXE, R. V.</creator><creatorcontrib>SWERDLOW, D. L. ; MALENGA, G. ; BEGKOYIAN, G. ; NYANGULU, D. ; TOOLE, M. ; WALDMAN, R. J. ; PUHR, D. N. D. ; TAUXE, R. V.</creatorcontrib><description>Between 23 August and 15 December 1990 an epidemic of cholera affected
Mozambican
refugees in Malawi causing 1931 cases (attack rate=2·4%); 86% of
patients had arrived in
Malawi <3 months before illness onset. There were 68 deaths
(case-fatality rate=3·5%);
most deaths (63%) occurred within 24 h of hospital admission which may
have indicated
delayed presentation to health facilities and inadequate early rehydration.
Mortality was higher
in children <4 years old and febrile deaths may have been associated with
prolonged IV use.
Significant risk factors for illness (P<0·05) in two
case-control studies included drinking river
water (odds ratio [OR]=3·0); placing hands into stored
household drinking water (OR=6·0);
and among those without adequate firewood to reheat food, eating
leftover cooked peas (OR=8·0). Toxigenic V. cholerae O1,
serotype Inaba, was isolated from patients and stored household
water. The rapidity with which newly arrived refugees became infected
precluded effective use
of a cholera vaccine to prevent cases unless vaccination had occurred
immediately upon camp
arrival. Improved access to treatment and care of paediatric patients,
and increased use of oral
rehydration therapy, could decrease mortality. Preventing future cholera
outbreaks in Africa
will depend on interrupting both waterborne and foodborne transmission
of this pathogen.</description><identifier>ISSN: 0950-2688</identifier><identifier>EISSN: 1469-4409</identifier><identifier>DOI: 10.1017/s0950268896007352</identifier><identifier>PMID: 9207730</identifier><identifier>CODEN: EPINEU</identifier><language>eng</language><publisher>Cambridge: Cambridge University Press</publisher><subject>Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Biological and medical sciences ; Case control studies ; Cholera ; Cholera - epidemiology ; Cholera - etiology ; Cholera - mortality ; Cholera - therapy ; Disease Outbreaks ; Disease transmission ; Diseases ; Epidemics ; Epidemiology ; Fluid Therapy ; Food Microbiology ; Human bacterial diseases ; Humans ; Infectious diseases ; Malawi - epidemiology ; Medical sciences ; Potable water ; Refugees ; Risk Factors ; River water ; Tents ; Water Microbiology</subject><ispartof>Epidemiology and infection, 1997-06, Vol.118 (3), p.207-214</ispartof><rights>1997 Cambridge University Press</rights><rights>Copyright 1997 Cambridge University Press</rights><rights>1997 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c623t-fcde3b94f4df0c26074b84e31be791edb5b45be8ea0e589ee74dedb950fdb13f3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4617355$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4617355$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>230,314,727,780,784,803,885,27924,27925,53791,53793,58017,58250</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2697917$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9207730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SWERDLOW, D. L.</creatorcontrib><creatorcontrib>MALENGA, G.</creatorcontrib><creatorcontrib>BEGKOYIAN, G.</creatorcontrib><creatorcontrib>NYANGULU, D.</creatorcontrib><creatorcontrib>TOOLE, M.</creatorcontrib><creatorcontrib>WALDMAN, R. J.</creatorcontrib><creatorcontrib>PUHR, D. N. D.</creatorcontrib><creatorcontrib>TAUXE, R. V.</creatorcontrib><title>Epidemic cholera among refugees in Malawi, Africa: treatment and transmission</title><title>Epidemiology and infection</title><addtitle>Epidemiol. Infect</addtitle><description>Between 23 August and 15 December 1990 an epidemic of cholera affected
Mozambican
refugees in Malawi causing 1931 cases (attack rate=2·4%); 86% of
patients had arrived in
Malawi <3 months before illness onset. There were 68 deaths
(case-fatality rate=3·5%);
most deaths (63%) occurred within 24 h of hospital admission which may
have indicated
delayed presentation to health facilities and inadequate early rehydration.
Mortality was higher
in children <4 years old and febrile deaths may have been associated with
prolonged IV use.
Significant risk factors for illness (P<0·05) in two
case-control studies included drinking river
water (odds ratio [OR]=3·0); placing hands into stored
household drinking water (OR=6·0);
and among those without adequate firewood to reheat food, eating
leftover cooked peas (OR=8·0). Toxigenic V. cholerae O1,
serotype Inaba, was isolated from patients and stored household
water. The rapidity with which newly arrived refugees became infected
precluded effective use
of a cholera vaccine to prevent cases unless vaccination had occurred
immediately upon camp
arrival. Improved access to treatment and care of paediatric patients,
and increased use of oral
rehydration therapy, could decrease mortality. Preventing future cholera
outbreaks in Africa
will depend on interrupting both waterborne and foodborne transmission
of this pathogen.</description><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Case control studies</subject><subject>Cholera</subject><subject>Cholera - epidemiology</subject><subject>Cholera - etiology</subject><subject>Cholera - mortality</subject><subject>Cholera - therapy</subject><subject>Disease Outbreaks</subject><subject>Disease transmission</subject><subject>Diseases</subject><subject>Epidemics</subject><subject>Epidemiology</subject><subject>Fluid Therapy</subject><subject>Food Microbiology</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infectious diseases</subject><subject>Malawi - epidemiology</subject><subject>Medical sciences</subject><subject>Potable water</subject><subject>Refugees</subject><subject>Risk Factors</subject><subject>River water</subject><subject>Tents</subject><subject>Water Microbiology</subject><issn>0950-2688</issn><issn>1469-4409</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtv1DAUhS0EKkPhByCBlEXFioAdO3bMolJVlbbqA1WUteXHzdRDEg92wuPf49FEEbBgZdnf8b33nIvQS4LfEUzE-4RljSveNJJjLGhdPUIrwrgsGcPyMVrtcLnjT9GzlDYYY1k14gAdyAoLQfEK3ZxtvYPe28I-hA6iLnQfhnURoZ3WAKnwQ3GjO_3Dvy1O2uit_lCMEfTYwzAWenD5pofU-5R8GJ6jJ63uEryYz0P05ePZ_elFef3p_PL05Lq0vKJj2VoH1EjWMtdiW3EsmGkYUGJASALO1IbVBhrQGOpGAgjm8ms20zpDaEsP0fG-7nYyPTibZ4m6U9voex1_qaC9-psM_kGtw3dVNbhpCM4F3swFYvg2QRpVdmCh6_QAYUqK8EpwzkQWkr3QxpBSTmVpQrDa7UB9_ncH-c_rP6dbfsyhZ340c52s7tocoPVpkVVc5hR2rV_tZZs0hrhgxjOr64zLPfZphJ8L1vGr4oKKWvHzO8VvL67YLb1Xd1lPZye6N9G7NahNmOKQ9_QfL78BmhO4nQ</recordid><startdate>19970601</startdate><enddate>19970601</enddate><creator>SWERDLOW, D. L.</creator><creator>MALENGA, G.</creator><creator>BEGKOYIAN, G.</creator><creator>NYANGULU, D.</creator><creator>TOOLE, M.</creator><creator>WALDMAN, R. J.</creator><creator>PUHR, D. N. D.</creator><creator>TAUXE, R. V.</creator><general>Cambridge University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>19970601</creationdate><title>Epidemic cholera among refugees in Malawi, Africa: treatment and transmission</title><author>SWERDLOW, D. L. ; MALENGA, G. ; BEGKOYIAN, G. ; NYANGULU, D. ; TOOLE, M. ; WALDMAN, R. J. ; PUHR, D. N. D. ; TAUXE, R. V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c623t-fcde3b94f4df0c26074b84e31be791edb5b45be8ea0e589ee74dedb950fdb13f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Bacterial diseases</topic><topic>Bacterial diseases of the digestive system and abdomen</topic><topic>Biological and medical sciences</topic><topic>Case control studies</topic><topic>Cholera</topic><topic>Cholera - epidemiology</topic><topic>Cholera - etiology</topic><topic>Cholera - mortality</topic><topic>Cholera - therapy</topic><topic>Disease Outbreaks</topic><topic>Disease transmission</topic><topic>Diseases</topic><topic>Epidemics</topic><topic>Epidemiology</topic><topic>Fluid Therapy</topic><topic>Food Microbiology</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infectious diseases</topic><topic>Malawi - epidemiology</topic><topic>Medical sciences</topic><topic>Potable water</topic><topic>Refugees</topic><topic>Risk Factors</topic><topic>River water</topic><topic>Tents</topic><topic>Water Microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SWERDLOW, D. L.</creatorcontrib><creatorcontrib>MALENGA, G.</creatorcontrib><creatorcontrib>BEGKOYIAN, G.</creatorcontrib><creatorcontrib>NYANGULU, D.</creatorcontrib><creatorcontrib>TOOLE, M.</creatorcontrib><creatorcontrib>WALDMAN, R. J.</creatorcontrib><creatorcontrib>PUHR, D. N. D.</creatorcontrib><creatorcontrib>TAUXE, R. V.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epidemiology and infection</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SWERDLOW, D. L.</au><au>MALENGA, G.</au><au>BEGKOYIAN, G.</au><au>NYANGULU, D.</au><au>TOOLE, M.</au><au>WALDMAN, R. J.</au><au>PUHR, D. N. D.</au><au>TAUXE, R. V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Epidemic cholera among refugees in Malawi, Africa: treatment and transmission</atitle><jtitle>Epidemiology and infection</jtitle><addtitle>Epidemiol. Infect</addtitle><date>1997-06-01</date><risdate>1997</risdate><volume>118</volume><issue>3</issue><spage>207</spage><epage>214</epage><pages>207-214</pages><issn>0950-2688</issn><eissn>1469-4409</eissn><coden>EPINEU</coden><abstract>Between 23 August and 15 December 1990 an epidemic of cholera affected
Mozambican
refugees in Malawi causing 1931 cases (attack rate=2·4%); 86% of
patients had arrived in
Malawi <3 months before illness onset. There were 68 deaths
(case-fatality rate=3·5%);
most deaths (63%) occurred within 24 h of hospital admission which may
have indicated
delayed presentation to health facilities and inadequate early rehydration.
Mortality was higher
in children <4 years old and febrile deaths may have been associated with
prolonged IV use.
Significant risk factors for illness (P<0·05) in two
case-control studies included drinking river
water (odds ratio [OR]=3·0); placing hands into stored
household drinking water (OR=6·0);
and among those without adequate firewood to reheat food, eating
leftover cooked peas (OR=8·0). Toxigenic V. cholerae O1,
serotype Inaba, was isolated from patients and stored household
water. The rapidity with which newly arrived refugees became infected
precluded effective use
of a cholera vaccine to prevent cases unless vaccination had occurred
immediately upon camp
arrival. Improved access to treatment and care of paediatric patients,
and increased use of oral
rehydration therapy, could decrease mortality. Preventing future cholera
outbreaks in Africa
will depend on interrupting both waterborne and foodborne transmission
of this pathogen.</abstract><cop>Cambridge</cop><pub>Cambridge University Press</pub><pmid>9207730</pmid><doi>10.1017/s0950268896007352</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0950-2688 |
| ispartof | Epidemiology and infection, 1997-06, Vol.118 (3), p.207-214 |
| issn | 0950-2688 1469-4409 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2808810 |
| source | MEDLINE; JSTOR Archive Collection A-Z Listing; PubMed Central |
| subjects | Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Case control studies Cholera Cholera - epidemiology Cholera - etiology Cholera - mortality Cholera - therapy Disease Outbreaks Disease transmission Diseases Epidemics Epidemiology Fluid Therapy Food Microbiology Human bacterial diseases Humans Infectious diseases Malawi - epidemiology Medical sciences Potable water Refugees Risk Factors River water Tents Water Microbiology |
| title | Epidemic cholera among refugees in Malawi, Africa: treatment and transmission |
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